• Title/Summary/Keyword: Lower Abdominal Pain

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Ileal epithelioid leiomyosarcoma with omental and peritoneal seeding (그물막과 복막파종을 동반한 회장의 상피양 평활근육종)

  • Kim, Chung-Hyoun;Kim, Sun-Young;Jung, Chang-Kil;Choi, Jung-Pil;Seo, Keum-Soo;Lee, Jun-Ho;Choi, Jae-Hyung
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.132-136
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    • 2017
  • Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.

A Case of Hepatic Vein Thrombosis Associated with Ulcerative Colitis (궤양성 대장염에 동반된 간정맥 혈전증 1예)

  • Kim, Joon-Sung;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.235-239
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    • 2009
  • Patients with inflammatory bowel disease are known to have hypercoagulability and an increased risk for venous thromboembolism. The deep veins of the lower extremities and the pulmonary veins are the most common sites of thrombosis in ulcerative colitis. However, hepatic vein thrombosis (Budd-Chiari syndrome) is a very rare extra-intestinal complication of ulcerative colitis in children. We describe a case of hepatic vein thrombosis in a 15-year-old girl with ulcerative colitis who presented with abdominal pain and hematochezia. Doppler ultrasonography and an abdominal CT scan revealed the characteristic filling defects caused by large thrombi in both hepatic veins. These lesions were successfully treated with conventional management for ulcerative colitis and anticoagulation therapy.

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5 Cases of Primary Infertility treated by Jokyungjongok-tang gamibang (조경종옥탕가미방(調經種玉湯加味方)을 병용한 원발성 불임환자 치험 5례(例))

  • Koo, Jin Suk
    • The Korea Journal of Herbology
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    • v.35 no.5
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    • pp.41-46
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    • 2020
  • Objectives : According to 2013 statistics, the primary infertility rate is 13.5%. The current situation is much worse than that reported, so it is even emerging as a social problem. The purpose of this study is to analyze the 5 cases of successful infertility treatment with herbal treatment and to give hope to the infertile couple to become pregnant and to suggest the possibility of herbal treatment in infertility treatment. Methods : We administered Jokyungjongok-tang gamibang as a herbal medicine and treated with acupuncture, moxibustion. Treatment was done once or twice a week. The herbal medicines were taken 30 minutes after meals and 3 times a day. While taking the herbal medicine, they were prohibited from eating flour, pork, liquor, tobacco and coffee. Patient status was assessed by consultation through pulse, tongue and abdominal diagnosis. The diagnosis of pregnancy was confirmed by ultrasonography at hospitals and the success of the treatment was judged based on healthy birth. Results : Patients had common features, such as lower abdominal pain, menstrual cramps, and blood clots during menstruation. Herbal medicine combined with acupuncture, moxibustion improved patients' overall fatigue and reduced the body's coldness. Since then, the dysmenorrhea and blood clots have decreased, and the digestion condition has improved. Therefore they became pregnant and gave birth to a healthy baby. Conclusion : Jokyungjongok-tang gamibang was effective in improving the body's coldness and uterine condition and was successful in pregnancy and helped to give birth to a healthy baby.

Cholangiocarcinoma: An-eight-year Experience in a Tertiary-Center in Iran

  • Mohammad-Alizadeh, Amir Houshang;Ghobakhlou, Mehdi;Shalmani, Hamid Mohaghegh;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5381-5384
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    • 2012
  • Background and Aim: Cholangiocarcinoma (CCA) is an uncommon malignancy of the bile duct, occurring in nearly 2 out of 100,000 people. It is a type of adenocarcinoma that originates in the mucous glands of the epithelium, or surface layers of the bile ducts. The aim of this study was to evaluate the clinical features, diagnostic results and factors associated with survival, morbidity and mortalityof cholangiocarcinoma cases in Iranian patients. Method: In this retrospective study the hospital medical records of 283 patients with a primary or final diagnosis of cholangiocarcinoma who had been admitted to gastroenterology ward of our hospital from 2004 to 2011 were retrospectively reviewed. Results: 283 patients (180 male, 63%, and 103 female, 38.6%) with a mean age of $59.7{\pm}14.4$ years were studied. The most frequent symptoms were painless jaundice (190, 66.9%), abdominal pain (77, 27%), pruritus 133 (46.8%) and weight loss (169, 59.5%). The most frequent associated risk factors and diseases were as follows: gallstones (72, 25.4%), diabetes (70, 24.6%), HBV infection (52 (18.3%), HCV infection 43 (15%), primary sclerosing cholangitis (16, 5.6%) and smoking (120, 42.3%). The most frequent type of cholangiocarcinoma in ERCP and MRCP was hilar. The mean survival time was $7.42{\pm}5.76$ months. Conclusion: The mean survival time in our study was lower than one year. Moreover the most frequent risk factors and associated diseases were smoking, gallstones and diabetes. Painless jaundice, abdominal pain and weight loss were the most clinical features related to cholangiocarcinoma. Additionally survival time did not correlate with risk factors, associated diseases and clinical presentations, but was linked to biliary metallic stenting and surgery.

Analysis of Somatostatin-Secreting Gastric Delta Cells according to Upper Abdominal Symptoms and Helicobacter pylori Infection in Children

  • Kim, Dong-Uk;Moon, Jin-Hwa;Lee, Young-Ho;Paik, Seung Sam;Kim, Yeseul;Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.3
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    • pp.243-250
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    • 2020
  • Purpose: Gastric delta cells (D-cells), which are somatostatin-secreting cells, are the main paracrine inhibitor of acid secretion. The number of D-cells was studied in children presenting with upper gastrointestinal (UGI) disease. Methods: We retrospectively investigated the number of D-cells in the gastric body and antrum through immunofluorescence examinations according to symptoms, endoscopic findings, and Helicobacter pylori infection in 75 children who visited Hanyang University Hospital Pediatrics. Results: The mean patient age was 12.2±3.3 years. The male-to-female ratio was 1:1.4. The mean D-cell number per high-power field in the antrum and body was 20.5 and 12 in children with substernal pain, 18.3 and 10.3 in vomiting, 22.3 and 6 in diarrhea, and 9.3 and 6 in abdominal pain, respectively (p>0.05). According to endoscopic findings, the mean D-cell number in the antrum and body was 14.3 and 6 with gastritis, 14 and 9.3 with reflux esophagitis, 16.7 and 8.7 with duodeno-gastric reflux, 19.3 and 12.7 with gastric ulcer, 16 and 13.7 with duodenitis, and 12.3 and 4 with duodenal ulcer, respectively (p>0.05). The D-cell number in the gastric body was 2.7 and 8.7 in children with current H. pylori infection and non-infected children, respectively (p=0.01), while those in the antrum were 15.5 and 14, respectively, with no statistical significance. Conclusion: The D-cell number was lower in the gastric body of children with current H. pylori infection. Further studies concerning peptide-secreting cells with a control group would provide information about the pathogenic pathways of UGI disorder.

A Case of $Henoch-Sch{\"{o}}nlein$ Purpura with Hemorrhagic Bullae in a Child (소아에서 출혈성 수포를 동반한 $Henoch-Sch{\"{o}}nlein$ 자반병 1례)

  • Oh Yeon-Mi;Jung Mi-Rim;Choi Hye-Jeong;Cha Hee-Jeong;Jeong Jin-Young
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.40-44
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    • 2006
  • [ $Henoch-Sch{\"{o}}nlein$ ] purpura(HSP) is a systemic small vessel vasculitis characterized by cutaneous purpura, arthritis, abdominal pain and nephritis. The characteristic rash of HSP consists of palpable purpura on the buttocks and lower extremities. Bullous lesions often appear in adults with HSP, whereas they are very rare in children with HSP. In this case report, the patient presented with arthralgia and abdominal pain and had hemorrhagic bullae as a prominent manifestation of the disease. The skin biopsy of the patient revealed typical leukocytoclastic vasculitis of dermal vessels and prominent IgA and fibrinogen deposits on capillary walls by direct immunofluorescence. We confirmed the diagnosis of HSP and observed improvement of clinical symptoms and signs within a few days after corticosteroid treatment. We therefore report a case with a review of the literature.

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Evaluation on Toxicity of Habitual dose of Extract of Rheum Palmatum through Single Blinded Pilot Study (단일맹검시험을 통한 대황(大黃) 상용량(常用量)의 독성작용 평가)

  • Kwon, Hyork;Chi, Gyoo-Yong;Eom, Hyun-Sup
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.3
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    • pp.390-400
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    • 2010
  • This study is aimed to test physiological and hematological actions of Rheum palmatum through clinical pilot study optimized for usual oriental medicine prescription. Thirty-one cases were finally collected and the sample extract 100 $m{\ell}$ of Rheum palmatum (ERP) was administered two times in a day during 3 days and checked with blood CBC test, urinalysis, liver function test, abdominal X-ray as well as general diagnostic process of oriental medicine; pattern identification, assessment of shapes and constitution. The total toxic effective rate of ERP was 9.68% in 3 cases of the whole in case of consistent uneasy state in the subjective symptomatic assessment and aggravation of blood and urine examination. The relevant diagnostic factors were so-eum constitution and essence type subject, carapaces species, lung type in the aspect of Jisan shape theory. On the other hand, the positive effective rate of ERP was 29.03% manifesting improvement of vital signs or present illness and no abnormal changes of blood chemistry and urinalysis and simple abdomen radiology. The relevant diagnostic factors were tae-eum constitution, energy type subject, aves species, heart and liver type in Jisan's shape theory. And the other cases were manifesting no specific change through the administration of ERP. The ratio of the numbers of decrease and increase was 44:5 in the tenderness and hardness of abdominal palpation. But if the pattern identification doesn't comply with the aim of rhubarb application despite of constipation and abdominal pain, the tendeness and biochemical report was shown in abnormal change. The mean number of diarrhea by ERP was $16.77{\pm}6.95$ during 3 days after administration, and the frequent areas of abdominal pain were lower>middle>upper in order, and it meant the target site of ERP too. Besides, the toxic reaction against ERP was expressed highly in case of decrease in blood cell count and hemoglobin, hematocrit having blood deficiency syndrome. Likewise, the toxicity of ERP was influenced by pattern identification manifesting present disease condition and diagnostic factors of four constitutions, Jisan's shape theory collaterally. In conclusion, evaluation of herbal toxicity in order for using as a clinical guideline, various diagnostic pattern information and shape features like the above should be studied together with other pharmacologic toxicology test for the future.

MRI Findings of Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA syndrome) with a Blind Megaureter: Case Report

  • Cho, Yun Hee;Sung, Deuk Jae;Han, Na Yeon;Park, Beom Jin;Kim, Min Ju;Sim, Ki Choon;Cho, Sung Bum
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.3
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    • pp.196-199
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    • 2015
  • Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is an uncommon congenital abnormality of the female urogenital tract characterized by the triad of uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. A 13-year-old female presented with acute lower abdominal pain. Magnetic resonance imaging (MRI) revealed uterine didelphys, hematometrocolpos, obstructed hemivagina, and right ipsilateral agenesis, consistent with OHVIRA syndrome. Also, a well-defined mass with fluid signal intensity, mimicking adnexal neoplasm was seen in the right lower pelvic cavity adjacent to the posterior wall of the bladder. Vaginal septotomy and drainage of hematometrocolpos were done initially, but unilateral hysterectomy was later performed to relieve the patient's symptoms. The cystic mass in the right lower pelvic cavity was also excised and confirmed as a blind megaureter.

Effects of Transversus Abdominal Muscle Stabilization Exercise to Spinal Segment Motion on Trunk Flexion-Extension (복횡근 강화운동이 체간 신전-굴곡 시 척추 분절 운동에 미치는 영향)

  • Kim, Suhn-Yeop;Baek, In-Hyeub
    • Physical Therapy Korea
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    • v.10 no.1
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    • pp.63-76
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    • 2003
  • This research was performed to compare spinal segment motion angle between low back pain (LBP) group and painless group during trunk flexion-extension and to investigate the effect of transversus abdominis strengthening exercise on spinal segment motion angle in LBP group. Nine subjects with LBP and ten subjects without LBP participated. Transversus abdominis strengthening exercise was performed in LBP group for three weeks, and spinal segment motion angles were compared before and after the exercise performance. Spinal segment motion angles were measured both in sitting and standing position. Results were as followed: 1) Subjects' average age was 24.79 years, height was 167.84 cm, and weight was 59.95 kg. 2) Spinal segment motion angle of T10/l1 was significantly higher in LBP group compared with painless group (p<.05) in sitting position during trunk flexion-extension. 3) In sitting position, whereas entire lumbar segment motion angles were lower in LBP group compared with painless group (p<.05), angle of L4/5 was higher in LBP group compared with painless group (p<.05). 4) There was no significant difference in thoracic segment motion angle in standing position. 5) After three weeks of transversus abdominis strengthening exercise, thoracic segment motion angle increased both in sitting and standing position (p<.05). 6) In painless group, there was no significant difference in entire spinal segment motion angles in sitting and standing position (p>.05). When spinal segment motion angles were compared between sitting and standing position, there were slight differences. In sitting position, there was no difference in spinal segment motion angle between LBP group and painless group while hip joint motion angle and sacral inclination angle of LBP group was lower than those of painless group (p<.05). In standing position, lumbar segment motion angle was significantly lower in LBP group than that of painless group. Transversus abdominis strengthening exercise influenced thoracic segment motion angle more significantly than lumbar segment motion angle.

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Pediatric Laparoscopic Splenectomy (소아의 복강경하 비장절제술)

  • Kim, Won-Woo;Kim, Eung-Kook;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.5 no.1
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    • pp.53-57
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    • 1999
  • Pediatric laparoscopic splenectomy has been gradually accepted as the surgical management of a various splenic disorders, particularly in hematologic diseases. We report our experience with 16 patients who underwent this procedure because of hematologic disorders during the past 3 and a half years at the Department of Surgery, St. Mary's Hospital, the Catholic University Medical College. The mean age was 10 years(range 6-16 years) and the mean spleen weight was 210 gm(range 85-500 g). The indication for splenectomy were hereditary spherocytosis(6 cases), idiopathic thrombocytopenic purpura(8 cases), autoimmune hemolytic anemia(1 case), and idiopathic splenomegaly(1 case). All splenectomies were performed safely with mean estimated blood loss of 233 ml. Mean operative time and mean postoperative hospital stay were 157 min and 4.5 days, respectively. Postoperative pain, medication was needed in 3 cases, just one injection in immediate postoperative period. Diet was started on the second or third postoperative day. In conclusion, laparoscopic splenectomy in pediatric patients is a safe procedure, offering a small of abdominal scar, much less pain, a shorter hospital stay and car the lower postoperative morbidity.

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